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Contact Information

LAKEWAY PHYSICAL THERAPY OUTPATIENT, PLLC
402-C CHURCH ST.
DOVER, TN37058
 Phone: 931-232-4555
 Fax: 931-232-4599
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy

261QP2000X
Indicates primary specialty

NPI Profile & details for LAKEWAY PHYSICAL THERAPY OUTPATIENT, PLLC

NPI # 1588809461
LBN Legal business name LAKEWAY PHYSICAL THERAPY OUTPATIENT, PLLC
Authorized official JOSELITO PASAOL - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 12/08/2008
Last updated 03/19/2012 - About 14 years ago
Identifiers
TN License # 0590012
TN Medicaid 1523011
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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